Social Care and the Church

Social Care and the Church

It is hardly headline news that social care is in major crisis in our country at the present time. The problems are highlighted in newspaper articles on a regular basis. If, like me, you keep copies of these articles, you soon build up a vast collection and most of them really tell the same things: the system is underfunded, there is a serious deficit in provision, vulnerable people do not always get the right levels of care, and politicians are struggling to find any real answer despite a plethora of reports. The situation is very unsatisfactory and what is disappointing in the light of all this is the silence, or at least muted voice, of the church of Jesus Christ.

This article therefore seeks to highlight some of the latest issues being raised, and to suggest an aspect of the problem that the church can speak to and act on. You will notice as you read the various press quotations that they were all written at around the same time. Similar sets could be produced for other dates. That simply illustrates that these issues are continually coming to the fore.

‘Don’t make us sell our homes!’ was the headline in the Daily Express on 3 October 2017. The sub-title said, ‘Pensioners’ anger at spiralling cost of social bills’. Quoting research by pensions experts Aegon, the article by Sarah O’Grady, their Social Affairs Correspondent, quoted a range of statistics about people’s attitude to funding social care:

Selling their property to raise funds is seen as a step too far for millions of homeowners but they admit taxpayers should not shoulder the burden of the nation’s care costs.

Two-thirds of those questioned believe any payments for social care should be shared between them and the Government.

Nine in ten want to see a cap on the contributions from individuals.

Only one in four believe the Government should pay all costs, perhaps recognising that this could place an unreasonable burden on future taxpayers as more people need social care in old age.

Two out of three people were against the proposals in the Conservative manifesto at the last election which suggested that the value of a person’s home should be included in any care assessment.

Almost three quarters of those aged 65-plus were against it.

More than half of 18-34 year olds were against it – although fewer of them owned property.

Unexpectedly, there was strong interest among 18-30 year-olds, which casts doubt on the perception that people leave thinking about funding social care until it is too late.

The Government is preparing yet again to consult on how to cover the costs of social care. Steven Cameron, pensions director at Aegon said: ‘As the Government prepares to consult on this controversial but hugely important topic, our research has shown a keen interest across the ages in finding a fair solution.’ When given a range of options regarding how they were likely to make advance provision for social care costs, two out of five said they would use their pension.

The present system for payment for Residential Care involves people contributing from their State Pension and also from other pensions and financial assets, with a contribution from the Local Authority unless the assets exceed £23,250. The difference between the combination of these sources and the actual cost of the Home will then be either met by the family, or the Home may have a two-tier charging system so that self-funders subside Local Authority-funded residents. Some voluntary organisations, like Pilgrims’ Friend Society (Pilgrim Homes), fund the difference from donations if family cannot support or are limited in the financial contribution they can make.

A significant element in the complex arrangements that are in place at the moment is the level of support that individual Local Authorities are able, or willing, to make. This is generally regarded as inadequate although the Local Authorities maintain they are at their limits in what they are paying. The problem of funding is having serious impacts for providers. For instance Four Seasons, who are probably Britain’s largest provider of care homes, are currently in very difficult financial circumstances. Much of the reason for that has to do with the way the company is financially constituted, but a significant further reason is the chaotic and inadequate way Local Authorities fund people who need a care home. Certainly in recent years many homes which have been run by voluntary organisations, and especially Christian groups and churches, have become financially unviable and have had to close.

The consumer group Which? have conducted a survey which shows that a quarter of elderly people who need residential care will be unable to find a bed in a local home within five years in some areas of the country (The Times, October 4, 2017). The research identified black spots where the provision of beds looks unlikely to keep up with growing numbers of people aged 80 and older who will need such care. Jane Morrison, chief executive of Independent Age said: ‘While this alarming research shows the shortfall in care home places predicted by the end of this parliament, we know there are already many older people and their families who are struggling to find a good quality care home.’

The crisis can be seen in this limited amount of provision and the deteriorating state of supply. Since 2010 35,000 day-care centres for the elderly have closed, and 1,600 care homes have shut in the last six years. As a consequence, one in ten NHS beds are now occupied by an elderly person who would have been discharged had provision been available. The situation is made even worse by the fact that many local authorities say that private agencies have pulled out of contracts to provide home visits and care because they are no longer financially viable. The whole system is creaking and seems ready to collapse. There are many quality care homes that provide excellent care and are still financially viable, but even they are under strain. There are also many care agencies that provide good care to people in their own homes and are also continuing to function within the very tight budgets they have. But there is little margin for innovation and development of new ideas.

As part of their response to all this Government ministers are highlighting attitudes within society as a significant factor in the problem. Jackie Doyle-Price is the Care Minister and she was reported to have said that families must learn from ethnic minority communities and take more responsibility for looking after elderly relatives (The Times, October 4 2017). She maintained that ‘as a society we’ve become less good at looking out for our neighbours, not just our families’. This is a rather contradictory position for a Conservative politician to take, since encouraging married women to work has been at the heart of some of their economic policies and working wives, along with increased social mobility, explain why many older people are not as supported by their families as they would have been in past generations. It should also be noted that a wholesale approval of Asian families’ care of their elderly, which is what Ms Doyle-Price and Jeremy Hunt are promoting, needs to be unpacked. Having run charities in Birmingham and Bristol which served older people and had extensive contact with Asian communities, I would be much more guarded in advocating they be copied. Let me say that Labour Party policies in this area are equally woolly and inadequate and that I have great respect for Asian people but their approach to care of the elderly would not be mine.

Justice Minister, Dr Phillip Lee, has added his voice to this attack on families. In the Mail Online, October 6 2017, he wrote that ‘Britain is a “selfish” society where families shirk their duty by “outsourcing” the care of their elderly relatives’. He added that ‘families needed to face up to “uncomfortable” truths about the demands of looking after elderly parents and grandparents, rather than expecting the state to care for them.’ Whilst there may be some truth in what Dr Lee is saying it is too generalised and fails to recognise how much some families are doing. One suggested way to help families care is to give tax breaks to those who do, or for legislation to enable people to take time off work to look after elders within the family.

Enough has probably been said to describe the problem and to show the challenge being faced by government and by families in responding to the problem of an ageing society and the increase of frail, elderly people. How should the church be responding to this? Let me suggest some areas for thought arising out of Acts 6:1-6 and 1 Timothy 5:1-16. The passages refer to widows, and as such identify an area of need in Apostolic times. John MacArthur, in his little book ‘Caring for Widows’ makes the point that ‘the Greek term “widow” (chera) means “bereft” and conveys a sense of suffering loss or being left alone. These are women who are vulnerable and needy.’ Such terms could also be applied to many older people, whether widows or not. The description of widows who are ‘really widows’ in 1 Timothy 5:5 clearly also covers many older people today. These are concerns that God has highlighted throughout the Bible – Psalm 68:5: ‘A father of the fatherless, a defender of widows, is God in his holy habitation.’

The early church took responsibility to support those in need. So in Acts 6 ministries of mercy clearly had a prominent place in the life of the church. It was to resolve the problems that were arising that the ‘deacons’ were appointed. In his epistle James emphasises this: ‘Pure religion and undefiled is this: to visit orphans and widows in their trouble and to keep oneself unspotted from the world.’ (James 1:27). Austin Walker, in his excellent book ‘God’s Care for The Widow’, identifies the church’s duty to widows as being: to visit them in their trouble; to relieve their needs; to comfort them in their distress. This is exactly the ministry older people need in their various situations and vulnerabilities. This is surely an area where the church needs to revive its ancient calling.

The men appointed to oversee the provision in Acts 6 appear to be among the ‘best’ men spiritually in the church. That surely illustrates the priority given to this group of needy people. Sadly, in many churches the leading people tend to do other things that they consider more significant. The growing demands of older people in our society, and especially in our churches, need the very best in our churches to be involved in organising their care.

This support may include financial inputs. The word ‘honour’ in 1 Timothy 5:3 has a financial element, as it does when referring to elders in verse 17. This idea of financial support is stated much more explicitly in 1 Timothy 5:16. That becomes very relevant as we consider the costs of care, and especially residence in a care home. Some churches endeavour to establish their own care provision, but that can be fraught with difficulties. Reviewing such establishments across the country one has to say that some are better than others! The main point here is that Paul expected churches to be involved in meeting the costs of care for their elderly people. Do we have the right to ignore these Scriptures in a day when older people are not being adequately provided for by the State?

Families carry a specific responsibility for the provision and funding of care for their elderly people. Paul sees children and grandchildren having a role to play (1 Timothy 5:4), and he emphasises the seriousness of this in verse 8. Failure to do this is considered to be extremely serious. The vehemence of Paul’s language is matched by that of the Lord himself in Mark 7:9-13. Fulfilment of the Fifth Commandment is seen in how families care for their elderly folk. Both Jesus and Paul are unequivocal in their expectations of families. This is something churches should be teaching their congregations and a failure to do so is an abrogation of responsibility by pastors and church leaders.

Providing need not necessarily mean actually doing the caring in every situation. The word for ‘provide’ in verse 8 has the sense of ‘provide in advance’, and refers to taking thought and planning the best provision possible. This should be done for ‘his own’, and whilst that refers to widows in the passage it is extended in verse 8 to ‘those of his household’. Paul is including children and old people. My wife and I cared for my wife’s father for seventeen years, but when my widowed mother developed dementia we knew that the best care for her would be at one of the Pilgrim Homes. And we did that even though my wife, who is a nurse, had run an Elderly Person’s Home, and I have specialised in working with older people and especially people with dementia; we knew where she would get the best care.

Particular care should be shown to their spiritual needs. Paul seems to give specific attention to this in Titus 2:1-3, where he deals with issues that should be taught in pastoral ministry to older people. Furthermore, the Apostle Paul addresses the whole issue of discipline and correction for older people in 1 Timothy 5:1-2. Whilst he is dealing with the manner in which older people should be addressed, he is also identifying that good care of older people will involve the delicate business of correction. What this teaches us is that the spiritual needs of older people should take a prominent place in pastoral care.

Older people still have ministries to fulfil and churches should be encouraging this. There is no certainty about what Paul meant by ‘taken into the number’ in 1 Timothy 5:9 in the New King James Version – ‘be enrolled’, ‘put on the list’ in other versions. What is said alongside this refers to the spiritual calibre and usefulness of some of these widows. Verse 5 describes these women as ladies who are given to prayer. The sort of person being considered is like Anna in Luke 2:26-37. Verse 10 shows a range of other areas of service. The rest of the Bible describes many areas of service for older people, and the care of them will involve enabling them to fulfil their callings to serve the Lord. It is not being faithful to God’s Word if we relegate our older people to a place of inactivity and no influence.

One significant implication of the above is that churches should consider supporting Christian organisations caring for older people. Such support may be regular financial giving, or encouraging members to engage with the organisations as volunteers, or directing older people to those organisations for help, support and especially a home. It seems the most extraordinary lack of understanding and care for older people when churches fail to direct their members to Christian care homes and subject believers to a potentially ungodly ethos in a non-Christian home.

These eight observations from these two passages and supported by other references show just how much the local church should be doing for older people. At a time when the care and support of older people is so manifestly lacking it is time for the church to be more active in this area and to demonstrate the practical implications of ‘loving one another’ (John 13:35).

Roger Hitchings

Roger Hitchings retired in 2011 from the pastorate of a small church in the East Midlands after 15 years of ministry. Previously he worked for 23 years in the field of social welfare with a particular emphasis on older people, and continues with that area of interest through writing and speaking.

(This article was originally published in the Affinity Social Issues Bulletin for November 2017. The whole edition can be found here.)